MRSA at the umbilicus!!

allnurses Guide · Jul 13, 2006

Our LDRP unit recently acquired the security system with the umbilical tags and we've had three cases of MRSA. The first was found on a baby we ended up transporting to the Children's Hospital downtown.
This is completely gross. Has anyone else had this happen? When we first got the system the tags were being sent down to be sterilized, but they stopped doing that for whatever reason. I think that's probably where it began, but management is busy "investigating these incidences" now. So we'll see what they have to say.
Anyone have any thoughts?

I've never heard of "umbilical tags". Certainly seems like a possible source to me.

steph

babyktchr, BSN, RN · Jul 13, 2006

Yikes...I think that the "not sterillizing" them anymore is your issue. Do they really have to work that hard to figure that one out? What worries me more though is....where did the MRSA come from to begin with to be growing on your sensors? Seems that your staff needs to have a bit of testing also.

We use those types of security sensors, but ours are sterilized routinely. I will pass this along though to make sure that never stops.

Please forward what you find out.

JVanRN · Jul 13, 2006

I'm still trying to figure out the need to put a security tag on the umbilicus. I'm just having a hard time picturing it. Why is this better as opposed to the ankle? What do they do when the umbilical cord falls off or if the kid has lines (well if you don't work in a NICU this probably isn't an issue)?

babyktchr, BSN, RN · Jul 13, 2006

the security sensors are attached to the cord clamp. We used to have the ankle ones but they fell off very frequently and the powers that be thought that the cord ones were a bit more reliable. They get put on at birth and cannot be taken off till the cord clamp is removed. It works just like a cord clamp.

SmilingBluEyes · Jul 14, 2006

That is why I am glad we use security sensors that attach to the infant's ankle, not cord. Infection control is certainly a concern at the healing umbilicus.

MrsCleverclogs · Jul 14, 2006

I am not surprised, after all the umbi is just rotting, dying flesh-hence why a few days on some really stink

dawngloves, BSN, RN · Jul 14, 2006

Our nursery does this too. We've only had one case of oomphalitis, that I'm aware of, in the 5 years I've been there.

mercytech · Jul 17, 2006

Ok, here's the update. Management says they've traced it back to the cord clamp remover (which is incidentally a specially designed model sold by the company who provides our tags). We will now be sending our tags down to Sterile Processing who will be sending them back up in individual sealed sterile packages which we will then be flipping onto our delivery tables.

They have also devised a cleaning procedure for the cord clamp remover in which after a single use we will be soaking it in disinfectant for five minutes and then rinsing with alcohol.

We were just having the discussion last night about the umbilical tags vs. ankle tags and we would rather have had the ankle tags, but we weren't consulted when the decision was made.

I'm really glad that we're going to be sterilizing the tags, I just think it's ridiculous that it took three cases of infection before the policy/procedure was put into place. :angryfire

prmenrs, RN · Jul 17, 2006

I just d/c'd a baby yesterday whose cord clamp was not removed because the cord was still too soft to safely remove it. That happens a fair amount of time because Mom and baby are d/c'd so quickly.

How would this system deal w/that circumstance?